Gait disturbance is an important feature of subcortical damage in patients with cerebral small vascular disease （CSVD）， which significantly increases the risk of falls. However， the mechanism of gait disturbance is still unclear. In this paper， we review the research progress in brain structural changes in CSVD patients with gait disturbance， including traditional imaging manifestations， gray matter volume （GMV）， cortical thickness （CTh）， and white matter microstructure. In traditional imaging findings， white matter hyperintensities （WMH） is mostly associated with gait disturbance， especially periventricular white matter hyperintensities and infratentorial WMH. There may be a threshold relationship rather than a dose-effect relationship between WMH severity and gait disturbance because only severe WMH leads to gait disturbance. In terms of GMV and CTh， CSVD patients with gait disturbance present significantly decreased GMV and CTh. In addition， diffusion tensor imaging shows that CSVD patients with gait disturbance have extensive damage in white matter microstructure including the fibers involved in higher cognitive control and descending motor tracts. Moreover， different white matter fiber structures may be related to specific characteristics of gait disturbance. This paper contributes to further understanding of the neural mechanism of gait disturbance in CSVD， but there are still many questions to be answered.Journal of International Neurology and Neurosurgery, 2021, 48(1): 77-80］